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[肝素治疗所致血小板减少症。达那肝素(Orgaran)的应用,13例单中心临时处方授权(ATU)病例]

[Thrombocytopenia due to heparin therapy. Use of danaparoid (Orgaran), 13 monocentric cases under authorization of temporary prescription (ATU)].

作者信息

Gindre L, de Maistre E, Perrin A, Lecompte T, Hoffman M A

机构信息

Service Pharmacie, Hôpital Brabois Adultes, Vandoeuvre les Nancy, France.

出版信息

Therapie. 1997 Nov-Dec;52(6):591-7.

PMID:9734113
Abstract

Since September 1994, danaparoid (Orgaran), a heparinoid, has been used in our centre to treat patients with thrombocytopenia occurring during heparin therapy and who need continuing antithrombotic therapy. We carried out a retrospective study using clinical and biological data on the first 13 consecutive patients treated with danaparoid (for 1 to 18 consecutive days). The platelet count returned to normal for ten patients, but one patient died having contracted a severe sepsis and bleeding occurred in one patient with acute renal failure. In the three other cases, the diagnosis of heparin induced thrombocytopenia (HIT) was in retrospect unlikely and the death of these patients was related to severe underlying diseases which were held responsible for thrombocytopenia. We confirm that danaparoid appears to be an effective, well-tolerated substitute for heparin in HIT patients. The French regulation Temporary Authorization for Prescribing Medicines allowed the prompt use of this as yet unmarketed drug and collection of reliable and pertinent data.

摘要

自1994年9月起,类肝素药物达那肝素(商品名:Orgaran)开始在我们中心用于治疗肝素治疗期间出现血小板减少且需要持续抗血栓治疗的患者。我们对连续接受达那肝素治疗(连续1至18天)的前13例患者的临床和生物学数据进行了回顾性研究。10例患者的血小板计数恢复正常,但1例患者因发生严重脓毒症死亡,1例急性肾衰竭患者出现出血。在其他3例中,回顾性分析发现肝素诱导的血小板减少症(HIT)诊断不太可能成立,这些患者的死亡与导致血小板减少的严重基础疾病有关。我们证实,达那肝素似乎是HIT患者中一种有效且耐受性良好的肝素替代药物。法国药品临时处方授权允许迅速使用这种尚未上市的药物并收集可靠且相关的数据。

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